Frequency Of Soft Tissue Injuries Research Articles

Prevalence and Patterns of Seizure-related Injuries: A Study of People Living with Epilepsy Found in a Community-based Door-to-door Survey in Southeast Nigeria.

Epileptic seizures and the unpredictable falls resulting from epileptic seizures predispose the people living with epilepsy (PLWE) to various physical injuries as well as postictal cognitive and behavioral changes. The aim of the study was to determine the frequency and patterns of seizure-related physical injuries, postictal cognitive impairments, and behavioral changes. This was a cross-sectional descriptive study in a Southeast Nigeria local government area. PLWE identified during a two-phase door-to-door survey and their caregivers were interviewed using a semi-structured questionnaire. The Statistical Package for the Social Sciences version 22.0 was used. There were 56 cases of active convulsive seizures comprising 33 (58.9%) males and 23 (41.1%) females, with a mean age of 32.9 ± 14.2. The lifetime prevalence of seizure-related physical injuries, postictal behavioral changes, and postictal cognitive impairments was 9.8 per 1000 (95% confidence interval [CI]: 9.1-10.0), 8.4 per 1000 (95% CI: 7.2-9.2), and 6.3 per 1000 (95% CI: 4.9-7.5), respectively. Skin/soft-tissue injuries and tongue laceration were the most frequent physical injuries found in 66.1% ( n = 37/56) and 60.7% ( n = 34/56) of cases, respectively. The frequency of soft-tissue injuries was significantly higher (χ 2 = 5.038; P = 0.0248) in the females 78.3% ( n = 18/23) than the males 48.5% ( n = 16/33). About a third of the females 39.1% had burn injuries compared to 18.1% of the males. Seizure-related injuries are common and have the tendency to increase the burden of epilepsy and epilepsy-related stigma from deformities and the chronic disfiguring scars resulting from such injuries.

Epidemiology of Craniofacial Soft Tissue Injury in a Western Chinese Population.

Craniofacial soft tissue injuries represent a serious public health problem and their epidemiology is extremely variable. The objective of the present study was to analyze and discuss the epidemiological characteristics of 12,816 patients with craniofacial skin soft tissue injuries over a 3-year period. This retrospective study was conducted in emergency departments of plastic surgery at Xijing Hospitals from 2020 to 2022. Data were collected for the cause of injury, age and gender distribution, localization and frequency of soft tissue injuries, visit time, facial bone fractures, nerve injury, and treatment protocols. All the data were analyzed and performed including descriptive analysis, chi-square test, and logistic regression analyses. A total of 13,574 soft tissue injuries were seen in 12,816 patients. A total to 94.67% (12,133) were single-site injuries, and 5.33% (683) were multiple-site injuries. The male-to-female ratio of 1.62:1. The age group 0 to 9 years accounted is the largest subgroup. The most common etiology of the trauma was collisions, accounted for 51.89%. The forehead (23.54%) was the most common site by the cheeks (14.36%). Two hundred three patients (1.58%) had associated bone fractures. May month had the highest incidence of trauma and February month had the lowest incidence. There are more visits on weekends than on weekdays. 18:00 to 24:00 is the time with the largest number of visits, but there is no statistically significant difference from other time periods. The average time interval between the accident and treatment was 6.8 hours, and the median time was 6 hours. The incidence of craniofacial soft tissue injuries is related to gender, age, and the cause of trauma. Children between 0 and 9 are the most likely group. Collisions is the main cause of craniofacial soft tissue injuries.

Epidemiology and Pattern of Pediatric Maxillofacial Trauma: A 5-Year Retrospective Study.

To analyze the epidemiology, pattern, and prevent measurement of pediatric maxillofacial trauma in Xinjiang, China. Clinical records of patients aged 0 to 18 years with maxillofacial trauma over the 5 years were reviewed. Epidemiological features of data were collected for the cause of injury, age and sex distribution, frequency and type of injury, localization and frequency of soft tissue injuries, facial bone fractures, and presence of associated injuries. Statistical analyses performed included descriptive analysis, χ 2 test, and logistic regression analyses. Among the 450 patients, 333 were male and 117 were female, with a male-to-female ratio of 3.8:1, the mean age was 9.2±5.4 years; 223 cases were soft tissue injuries and 227 cases were maxillofacial fractures. The 16 to 18-year-old group was the highest, with the prevalence of maxillofacial fractures. The most common cause of pediatric maxillofacial trauma was traffic injuries. The incidence of maxillofacial trauma in pediatric patients correlates with a number of factors, including age, sex, and etiology of trauma. The 16 to 18-year-old group is the most prevalent group for maxillofacial trauma in pediatric patients, and traffic accidents are the leading cause of maxillofacial trauma in pediatric patients.

Epidemiology and Pattern of Oral and Maxillofacial Trauma.

Maxillofacial trauma represents a serious public health problem and their epidemiology is extremely variable.The objective of the present study was to analyze and discuss the epidemiological characteristics of 2492 patients with oral and maxillofacial trauma over a 5-year period. This retrospective study was conducted at different hospitals of Xinjiang from 2012 to 2016. Data were collected for the cause of injury, age and gender distribution, frequency and type of injury, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, presence of associated injuries, nerve injury, different treatment protocols. All the data were analyzed using statistical analysis that is chi squared test.Statistical analyses performed included descriptive analysis, chi square test, and logistic regression analyses. A total of 2492 maxillofacial trauma patients were seen in 1981 patients with a male to female ratio of 3.88:1. The age group 21 to 30 years accounted for the largest subgroup in both sexes. The most common etiology of the trauma was traffic accident, accounted for 41.8%. The mandible (31.97%) was the most common site of fracture followed by the zygoma (25.3%). The common type associated injuries was limb injury (27.5%), it was followed by brain (24.5%) and eye (21.4%) injuries. The common nerve injury was the facial nerve injury, accounting for 62.9%. The incidence of oral and maxillofacial trauma is related to gender, age, and the cause of trauma. Young adults are the most likely group (P < 0.05). Maxillofacial trauma is often associated with limb, craniocerebral, and eye injuries. Traffic accident is the main cause of maxillofacial injury (P < 0.5).

“Piezosurgery vs bur in impacted mandibular third molar surgery: Evaluation of postoperative sequelae”

Piezosurgery is a relatively novel, precise and safe technique of ostectomy in the domain of oral and maxillofacial surgery. Our aim was to compare the inflammatory outcomes of osteotomy using piezosurgery and conventional bur in impacted mandibular third molar (IM3M) surgery. The study implemented a randomized, double-blind, crossover design. 120 sides in 60 patients were randomly allocated to the two interventions used, viz; conventional bur and piezosurgery. The primary outcome variables evaluated were facial swelling, trismus, pain, and paresthesia. Additionally, the duration of surgery and the frequency of soft tissue injuries with the use of two techniques were also evaluated. Pain, swelling, trismus, and soft tissue injuries emerged to be significantly higher with the use of bur as compared to the piezo. The duration of surgery was significantly extended in the piezo group and no significant difference was observed in the occurrence of paresthesia between the two groups. The result suggests that piezosurgical osteotomy technique is superior to conventional bur in terms of the postoperative inflammatory outcomes in IM3M surgery.

Correlation Between Soft Tissue Injury and the Type of Nasal Fracture Based on Stranc-Robertson Classification.

Nasal fractures are the most common facial bone fractures, and soft tissue injuries are frequently accompanied. This study intends to make a deep analysis on the relationship between the 2.Patients diagnosed with nasal fracture between 2015 and 2017 were included. Patients younger than 17 years and those with previous facial fractures or aesthetic surgeries were excluded. Nasal fractures were classified according to the Stranc-Robertson (S-R) classification, and the severity of soft tissue injury was evaluated by length and depth. The authors compared the frequency of soft tissue injury between frontal and lateral groups. Second, the authors investigated whether the incidence of soft tissue injuries increases as a function of the increase in the S-R classification both in frontal and lateral group (from plane I to III). The authors also analyzed the difference in severity of soft tissue injuries in each group. Pearson chi-square analysis, linear by linear and Jonckheere-Terpstra tests were used for statistical analysis.Of 621 patients, 296 were frontal plane and 325 were lateral plane. The frontal group had a higher incidence of soft tissue injury than the lateral group (P = 0.004). The incidence of soft tissue injury and severity by depth increased as a function of the increase in the S-R classification only in the frontal group (P = 0.046, 0.019).In nasal fractures, frontal impact is more associated with frequency and severity of soft tissue injury than lateral impact. This seems to be related to the anatomical characteristics of nasal area and mechanism of injuries in each group.

Facial Fractures.

The aim of this study is to retrospectively analyze the incidence of facial fractures along with age, gender predilection, etiology, commonest site, associated dental injuries, and any complications of patients operated in Craniofacial Unit of SDM College of Dental Sciences and Hospital. This retrospective study was conducted at the Department of OMFS, SDM College of Dental Sciences, Dharwad from January 2003 to December 2013. Data were recorded for the cause of injury, age and gender distribution, frequency and type of injury, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, complications, concomitant injuries, and different treatment protocols.All the data were analyzed using statistical analysis that is chi-squared test. A total of 1146 patients reported at our unit with facial fractures during these 10 years. Males accounted for a higher frequency of facial fractures (88.8%). Mandible was the commonest bone to be fractured among all the facial bones (71.2%). Maxillary central incisors were the most common teeth to be injured (33.8%) and avulsion was the most common type of injury (44.6%). Commonest postoperative complication was plate infection (11%) leading to plate removal. Other injuries associated with facial fractures were rib fractures, head injuries, upper and lower limb fractures, etc., among these rib fractures were seen most frequently (21.6%). This study was performed to compare the different etiologic factors leading to diverse facial fracture patterns. By statistical analysis of this record the authors come to know about the relationship of facial fractures with gender, age, associated comorbidities, etc.

Pediatric Facial Fractures: A 10-year Study.

The aim of the study is to retrospectively analyse the incidence of facial fractures along with age, gender predilection, etiology, commonest site, associated dental injuries and any complications of paediatric patients operated in Craniofacial unit of SDM college of dental sciences and hospital. This retrospective study was conducted at the department of OMFS, SDM College of Dental Sciences, Dharwad from January 2003-December 2013. All the patients below 15years of age were included in the study. Data were recorded for the cause of injury, age and gender distribution, frequency and type of injury, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, complications, concomitant injuries and different treatment protocols. A total of 68 cases of paediatric fracture were treated during these 10years. Boys were commonly injured than girls with a ratio of 2.9:1, the commonest cause of trauma was fall (59%), mandible was the commonest bone to be fractured (83%), treatment protocols were dependant on the age, region and type of fracture but in most of the cases closed reduction was the choice of treatment, dental injuries were seen in 26% patients and the commonest injury was avulsion. This study was done not only to analyse the different types of facial fractures and the pattern of fracture of paediatric cases admitted at this centre, but also to act as a contributional data which will help us to take preventive measures to avoid such injuries and make the appropriate treatment plan and execute it to achieve the pre-injury status of form and function.

Pattern of road traffic injuries in patients admitted to Al-jlaa Hospital, Benghazi, Libya

The developing countries bear a large share of burden and account for about 85% of the deaths as a result of road traffic accidents. In Libya, accidents cost the country about $160 million in 1978. The factors that affect accident rates and severity are divided into behavioral and structural ones. The present study was carried out to determine the incidence of fatal vehicular accidents and patterns of injuries among road traffic injury victims brought to Al-jlaa Hospital (Benghazi, Libya). A total of 2630 patients with road traffic injuries were registered at Al-jlaa Hospital. The data reported in the present study were collected between January 2009 and December 2009. Data were collected, including medical history, patient symptoms, clinical signs, and the radiological findings. A systematic method was used for the clinical examination of the traumatized region. Data of patients were recorded, including age, sex, time of occurrence, types of road users, frequency and type of injury (frequency of soft tissue injuries and bone fractures), outcomes, ICU admission, duration of survival as well as the period of hospitalization until death. Furthermore, an optimal combination of radiographic imaging was ascertained and computed tomography was found to be the single most informative mode of imaging. The Glasgow Coma Scale was used to assess the severity of brain injury. The Abbreviated Injury Scale scorings were performed according to the guidelines in the Abbreviated Injury Scale 2005 edition. A conservative or an operative intervention performed for all the cases was also recorded.

Pattern of craniofacial injuries in patients admitted to Tanta University Hospital – Egypt

The goal of this work was to determine the craniofacial injury patterns in hospitalized patients to facilitate the awareness, by identifying, describing and quantifying trauma for use in planning and evaluation of preventive programs. Two-hundred and fifty five patients with craniofacial injuries were registered at the department of neurosurgery in Tanta University Hospital. Data were collected including age, gender, medical history, cause of injury and type of injury, location and frequency of soft tissue injuries, skull fractures, facial bone fractures, brain injuries and concomitant injuries, patient symptoms, clinical signs and the radiological findings. The most common causes of craniofacial injuries were road traffic accidents, followed by activity of daily life and assaults. Gender distribution showed that, males were at higher risk than females with a ratio of 5.5/1. In total of skull fractures, 47.84% were fissure fracture and 24.31% were depressed fractures. In total of brain injuries, 7.06% for concussion, 4.71% for contusion, 10.98% for brain laceration, 14.12% for pneumocephalus and 36.47% for brain edema. Regression analysis revealed increased risk for skull fractures and brain injuries in traffic accidents were 84.78%, 94.20%, respectively, and 59.14%, 50.54% in activity of daily life, but the probability of soft tissue injuries increase in traffic accident and violence.

Arthroscopic Evaluation of Soft Tissue Injuries in Tibial Plateau Fractures: Retrospective Analysis of 98 Cases

This investigation arthroscopically assesses the frequency of soft tissue injury in tibial plateau fracture according to the severity of fracture patterns. We hypothesized that use of arthroscopy to evaluate soft tissue injury in tibial plateau fractures would reveal a greater number of associated injuries than have previously been reported. From March 1996 to December 2003, 98 patients with closed tibial plateau fractures were treated with arthroscopically assisted reduction and osteosynthesis, with precise diagnosis and management of associated soft tissue injuries. Arthroscopic findings for associated soft tissue injuries were recorded, and the relationship between fracture type and soft tissue injury was then analyzed. The frequency of associated soft tissue injury in this series was 71% (70 of 98). The menisci were injured in 57% of subjects (56 in 98), the anterior cruciate ligament (ACL) in 25% (24 of 98), the posterior cruciate ligament (PCL) in 5% (5 of 98), the lateral collateral ligament (LCL) in 3% (3 of 98), the medial collateral ligament (MCL) in 3% (3 of 98), and the peroneal nerve in 1% (1 of 98); none of the 98 patients exhibited injury to the arteries. No significant association was noted between fracture type and incidence of meniscus, PCL, LCL, MCL, artery, and nerve injury. However, significantly higher injury rates for the ACL were observed in type IV and VI fractures. Soft tissue injury was associated with all types of tibial plateau fracture. Menisci (peripheral tear) and ACL (bony avulsion) were the most commonly injured sites. A variety of soft tissue injuries are common with tibial plateau fracture; these can be diagnosed with the use of an arthroscope. Level III, diagnostic study.

Craniomaxillofacial trauma in children: a review of 3,385 cases with 6,060 injuries in 10 years

Purpose Trauma is the leading cause of diseases and death in children. The goal of this study was to assess the impact of the main causes of accidents among children resulting in pediatric craniomaxillofacial trauma. Patients and methods Between 1991 and 2000, data for 3,385 patients younger than 15 years of age who sustained a total of 6,060 craniomaxillofacial injuries were recorded for cause of injury, age and gender distribution, frequency and type of injury, injury mechanisms, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, and concomitant injuries. Univariate statistical analyses were followed by logistic regression analyses for the 3 injury types to determine the impact of the main injury causes on the type of injury at different ages in pediatric facial trauma patients. Results Play (58.2%), sport (31.8%), and traffic accidents (5%), acts of violence (3.9%), and other causes (1.1%) were noted. A total of 389 patients (11.5%) had 615 fractures, 2,582 patients (76.3%) had 3,384 dentoalveolar injuries, and 1,697 patients (50.1%) had 2,061 soft tissue injuries. The girl-to-boy ratio was 3:5, and the mean age was 7 ± 4.4 years. For children sustaining facial trauma, logistic regression analyses revealed increased risks for fractures (+238%) and soft tissue lesions (+89%) in children involved in traffic accidents. Dental trauma was more frequent (>+38%) in both sport and play accidents (all P < .001). Conclusions This study dissected the distinct impact of injury mechanisms in pediatric craniomaxillofacial trauma. Logistic regression analyses revealed statistically highly significant outcome differences in pediatric facial trauma depending on the injury mechanism.

Cranio-maxillofacial trauma: a 10 year review of 9543 cases with 21 067 injuries

Introduction: Cranio-maxillofacial trauma management requires pertinent documentation. Using a large computerized database, injury surveillance and research data describe the whole spectrum of injuries. The goal of this study was to assess the effect of the five main causes of accidents resulting in facial injury on the severity of cranio-maxillofacial trauma. Patients and Methods: During a period of 10 years (1991–2000) 9543 patients were admitted to the Department of Oral and Maxillofacial Surgery, University Hospital of Innsbruck with cranio-maxillofacial trauma. Data of patients were prospectively recorded including cause of injury, age and gender, type of injury, injury mechanisms, location and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures and concomitant injuries. Statistical analyses performed included descriptive analysis, chi square test, Fisher's exact test, and Mann–Whitney's U test. This was followed by logistic regression analyses for the three injury types to determine the impact of the five main causes on the type of injury at different ages in facial trauma patients. Results: Five major categories/mechanisms of injury existed: in 3613 (38%) cases it was activity of daily life, in 2991 (31%) sports, 1170 (12%) violence, in 1116 (12%) traffic accidents, in 504 (5%) work accidents and in 149 (2%) other causes. A total of 3578 patients (37.5%) had 7061 facial bone fractures, 4763 patients (49.9%) suffered from 6237 dentoalveolar, and 5968 patients (62.5%) from 7769 soft tissue injuries. Gender distribution showed an overall male-to-female ratio of 2.1 to 1 and the mean age was 25.8±19.9 years; but both varied greatly depending on the injury mechanism (facial bone fractures: 35.4±19.5 years, higher risk for males; soft tissue injuries: 28.7±20.5, no gender preference; dentoalveolar trauma: 18±15.6, elevated risk for females). For patients sustaining facial trauma, logistic regression analyses revealed increased risks for facial bone fractures (225%), soft tissue lesions (58%) in patients involved in traffic accidents, and dental trauma (49%) during activities of daily life and play accidents. When compared with other causes, the probability of suffering soft tissue injuries and dental trauma, but not facial bone fractures, is higher in sports-related accidents, 12 and 16%, respectively. Conclusion: This study differentiated between injury mechanisms in cranio-maxillofacial trauma. The specially trained surgeons treating cranio-maxillofacial trauma are the primary source of information for the public and legislators on implementing preventive measures for high-risk activities. In facial trauma, older persons are prone to bone fractures (increase of 4.4%/year of age) and soft tissue injuries (increase of 2%/year of age) while younger persons are more susceptible to dentoalveolar trauma (decrease of 4.5%/year of age).

Cervical spine injuries associated with lateral mass and facet joint fractures: diagnosis and treatment strategies

Purpose of study: The objectives of this study were to analyze the surgical results of cervical spine injuries associated with lateral mass and facet joint fractures retrospectively and to clarify the surgical indication and treatment strategies for these injuries.Methods used: From 1991 to 1999, 30 patients including 20 lateral mass fractures and 8 facet joint fractures received surgical treatments in our institution. The average age at surgery was 46 years. The injury types according to Allen's classification were compressive-extension in 26, lateral flexion in 3, and distractive-flexion in 1 patient. All patients, except one who required osteosynthesis for the separation fracture of the lateral mass, received exclusive posterior fusion with cervical pedicle screw system. From X-rays and magnetic resonance imaging (MRI) analyses, the fractures were classified into subtypes. The translation of fractured and adjacent vertebrae in the sagittal and coronal planes, vertebral body destruction and signal changes of disc and spinal ligaments (ALL, PLL, SSL and ISL) on MRI were evaluated. The number of stabilized segments and the spinal alignment were also evaluated at follow-up.of findings: The lateral mass fractures were divided into the following four subtypes: separation fracture in 11, comminution type in 4, split type in 5 and traumatic spondylolysis in 2. The superior and inferior articular process fractures and combination of both fractures were seen in six, one and one patient, respectively. The anterior translation of fractured vertebra was demonstrated in 77% of lateral mass fractures, whereas 24% and 10% of anterior translation was observed even in cephalad and caudal adjacent vertebrae, respectively. The alignment change in coronal plane was detected in 33% of lateral mass fractures. On MRI, the signal changes in ALL and disc were demonstrated in 76% and 25% of caudal and cephalad segments adjacent to fractured vertebra, respectively. The number of stabilized segments were 1.4, 1.67 and 2 in separation, comminution and split type, respectively. The fusion was completely achieved in all patients. However, the preservation of spinal segments resulted in fusion with the mild anterior translation in six patients.Relationship between findings and existing knowledge: Little is known about the detailed fracture type of lateral mass/facet fractures, initial instability, and a frequency of soft tissue injury. This study first analyzed these parameters.Overall significance of findings: The evaluation of spinal instability as well as the assessment of soft tissue injury on initial MRI was essential for the diagnosis and treatment of lateral mass and facet fractures. We successfully saved the stabilized segments in separation fractures or fractures with mild comminution based on the adjacent disc and ligaments evaluation. However, severely comminuted lateral mass fractures with coronal plane malalignment required two-level posterior fixation. The exclusive posterior stabilization with cervical pedicle screw system provides a short fusion as well as a normal spinal alignment even in the lateral mass fractures with severe spinal instability.Disclosures: Device or drug: cervical pedicle screw. Status: not approved.Conflict of interest: No conflicts.

Tibial Plateau Fractures

Tibial plateau fractures can occur concomitant with injuries to the collateral and cruciate ligaments, menisci, and surrounding nerves and arteries. The purpose of this article is to record the frequency of these soft tissue injuries with tibial plateau fractures. Patients with plateau fractures were entered into a prospective protocol consisting of radiographic evaluation, Schatzker classification, pre- and postfixation stress testing, and diagnostic arthroscopy. Thirty tibial plateau fractures were evaluated in this study. There was a 56% (17 of 30) frequency of associated soft tissue injuries in this series of tibial plateau fractures. The medial collateral ligaments were injured in 20% (six of 30), the lateral collateral ligaments in 3% (one in 30), the menisci in 20% (six in 30), the peroneal nerve in 3% (one in 30), and the anterior cruciate ligaments in 10% (three in 30). Schatzker type IV and type II fracture patterns were associated with the highest frequency of soft tissue injuries. Medical collateral ligament injuries were most commonly associated with Schatzker type II fracture patterns. Menisci were most commonly injured with Schatzker type IV fracture patterns. Based on the findings, routine arthroscopy should be indicated in nondisplaced Schatzker type I fractures. Pre- and postfixation stress testing should be performed to diagnose collateral and cruciate ligament injuries.